舌・口底切除後の語音発語明瞭度 切除範囲および手術法との関連について

Abstract

The relation between the surgical excisions or operation methods and speech intelligibility was investigated on 22 glossectomees (11 underwent direct suture, 4 received split-skin grafts and 7 received reconstruction with the free radial forearm flap).Articultory function after glossectomy was assessed mainly by using 100 Japanese syllable speech intelligibility test.Our results are summarized as follows;1. Speech intelligibility after glossectomy is related to the extent of resected tongue tissue.2. According to glossal sounds, subjects with more than half of the tongue resected showed low intelligibility scores for sounds produced with the rear portion of the tongue.3. The glossectomees showed improvement in speech intelligibility for about six months after their operation, reaching a plateau thereafter. According to glossal sounds, speech intelligibility of the sounds produced with the rear portion of the tongue showed remarkable improvement.4. Comparing the surgical methods among subjects with the same extent of resection, higher speech intelligibility was observed in those treated with split-skin graft and free radial forearm flap reconstruction than in those treated by direct suture.5. Free radial forearm flap reconstruction has the advantage of high speech intelligibility scores for the sounds produced with the rear portion of the tongue and for plosive sounds.6. Articulatory function after glossectomy was observed to be influenced more by flexibility of the remaining tongue tissue than by its volume. Therefore, operation methods of preserving the tip of the tongue and conserving the mobility of the rear portion of the tongue should be selected for minimizing post glossectomy speech disorders.